Completing a diagnostic conceptualization

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COUN_6720_DiagnosticConceptualizationTemplate.doc

Diagnostic Conceptualization Template

Client Name

     

Case Conceptualization ( Note: Include specific information about client symptoms and presenting concerns

     

Diagnostic Impressions (Note: Be sure to use the ICD-10 code, name of the disorder, and all of the specifiers)

     

Rationale for Diagnostic Impressions (Note: Use the DSM-5 to explain how the client’s symptoms are reflected in the diagnostic criteria for each diagnosis that you render. If you do not render a diagnosis, you still must use the DSM-5 to explain why you chose not to render a diagnosis.)

     

Cultural and Ethical Considerations (Note: Include information that may be pertinent to the diagnosis).

     

Student Name and credentials (e.g., Frida Kahlo, B.A.)

     

Date

     

COUN 6720 DIAGNOSTIC CONCEPTUALIZATION TEMPLATE Page 2 of 2